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The National Health Service Act 1946, which set up the NHS in England and Wales, contained a provision that NHS services should be provided free of charge unless that Act expressly provided for a charge. This provision has been carried forward into the legislation which replaced the 1946 Act – the NHS Act 1977 and subsequently the NHS Act 2006.

Since the founding of the NHS, amendments to legislation have been made allowing charges for NHS services including prescription, dental and optical charges.

This briefing paper sets out the provisions for various NHS charges, which groups are exempt, and explains where charges vary in the devolved nations.

It also includes a short note on delivery charges for prescriptions. In all parts of the UK, these are mainly left to the discretion of pharmacy groups.

It also briefly examines the future of NHS charges. In the context of financial pressure on the NHS, there have been calls for the introduction of additional charges for services, such as GP appointments, although there have been no Government plans to introduce further charges.

The paper also details reaction to the Covid-19 outbreak, specifically on calls to suspend prescription charges in England for its duration.

NHS charges for overseas visitors and NHS hospital car parking charges are detailed in separate House of Commons Library Briefings.

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